Intervention Increases Activity, Healthy Eating in Severe Mental Disorders

Patients with severe mental disorders can improve their physical activity and eating behaviors, according to findings from a real-world, randomized controlled trial published in Psychiatry Research.

Researchers conducted the LIFESTYLE study at 3 outpatient clinics in Italy. Patients (N=401) with a primary diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, major depressive disorder, bipolar disorder, or other psychotic disorders were randomly assigned in a 1:1 ratio to receive either the lifestyle psychosocial group intervention (n=206; 55.3% women; mean age, 45.9 years) or the brief psycho-educational group intervention (n=195; 59.0% women; mean age, 45.35 years).

Among the patients in the intervention and control groups, 89% and 85% had bipolar disorder, and 54.4% and 59.1% engaged in low physical activity at baseline, respectively.

Groups of 5 to 10 patients received the lifestyle intervention every 7 to 10 days during the course of 5 months. During the sessions, patients discussed healthy diet, physical activity, medication adherence, and risky behaviors, then engaged in 20 minutes of moderate physical activity. Patients in the control group received education about healthy lifestyle, clinical relapse, pharmacological management, and problem-solving techniques. Changes in physical activity and eating behaviors were evaluated after 6 months.

At the 6-month follow-up visit, patients in the intervention group had increased the median physical activity metabolic equivalents significantly from 519.5 minutes per week at baseline to 693.00 minutes per week at 6 months (P <.001). No significant change was observed among the controls.

The intervention group reported consuming more fish (P <.001) and fresh fruits (P <.01), and fewer cereals (P <.01) and junk food (P <.01) at 6 months compared with baseline. Patients in the control group reported increased consumption of junk food (P <.01) and red meat (P <.01) at 6 months compared with baseline.

The intervention was associated with increased total metabolic equivalents (odds ratio [OR], 8.02; 95% CI, 6.84-9.42; P <.001), metabolic equivalents from walking (OR, 7.68; 95% CI, 6.17-8.77; P <.001), more consumption of vegetables (OR, 1.98; 95% CI, -1.26 to 3.30; P <.05), and reduced consumption of junk food (OR, 0.23; 95% CI, -0.73 to 0.37; P <.05).

This study was limited by the high dropout rate, as only 94 in the experimental group and 83 in the control group completed the study.

Study authors concluded, “The LIFESTYLE experimental intervention improves physical activity and dietary patterns in patients with severe mental disorders. Our findings clearly show that patients with severe mental disorders can improve their lifestyle behaviors and that, with appropriate support, they can achieve a healthy living. There is the urgent need to implement similar interventions in routine clinical practice if we want to reduce the mortality gap in patients with severe mental disorders.”